Local governments struggle to distribute share of opioid settlement

Settlement money to help stem the decades-long opioid addiction and overdose epidemic is rolling out to small towns and big cities across the U.S., but advocates worry that chunks of it may be used in ways that don’t make a dent in the crisis.

As state and local governments navigate how to use the money, advocates say local governments may not have the bandwidth to take the right steps to identify their communities’ needs and direct their funding shares to projects that use proven methods to prevent deaths.

Opioids have been linked to about 800,000 deaths in the U.S. since 1999, including more than 80,000 annually in recent years, with most of those involving illicitly produced fentanyl.

Drugmakers, wholesalers and pharmacies have been involved in more than 100 settlements of opioid-related lawsuits with state, local and Native American tribal governments over the past decade.

The deals, some not yet finalized, could be worth a total of more than $50 billion over nearly two decades and also come with requirements for better monitoring of prescriptions and making company documents public.

States alone fought the tobacco industry in the 1990s and they used only a sliver of the money from the resulting settlements on tobacco-related efforts.

“We don’t want to be 10 years down the road and say, ‘After we screwed up tobacco, we trusted small government with opioids — and we did even worse,’” said Paul Farrell, Jr., one of the lead lawyers representing local governments in the opioid suits.

He notes that with settlement money rolling out for at least 14 more years, there’s time for towns to use it appropriately, and resources to help.

The goal, experts say, is to help those who are taking opioids to get treatment, to make it less likely people who use drugs will overdose and to create an environment for people not to take them in the first place.

The major opioid settlements, which include deals with Walgreen Co., CVS Health, Walmart, Johnson & Johnson and one with Oxycontin maker Purdue Pharma that is before the U.S. Supreme Court, require that most of the funds be used to combat the crisis.

More than half of the funds will be controlled by local governments, according to Christine Minhee, who runs the Opioid Settlement Tracker website. In the biggest agreements, states receive larger amounts by getting eligible local governments with populations over 10,000 to join the settlements.

In Arkansas, all the towns and counties pooled their money by creating the Arkansas Opioid Recovery Partnership.

Grants have gone to a drug task force to hire an overdose investigator and peer recovery specialist, for the American Indian Center of Arkansas to hire peer recovery specialists, and for a religious organization to expand its recovery housing center in projects ranging from $100,000 to more than $2 million.

Kirk Lane, a former police chief and director of state drug policy who now serves as director of the partnership, said it’s able to steer projects to underserved parts of the state and to fill in gaps in the state’s treatment, recovery and prevention systems.

He explained, “Individual mayors and county judges didn’t have to worry about, ‘How are we going to spend that money?’”